De-escalation of Surgical Intervention and Contemporary Management Recommendations for Lobular Neoplasia, Atypical Ductal Hyperplasia, and Ductal Carcinoma In Situ
Abstract
Purpose of ReviewIn which patients is it oncologically safe to offer active surveillance instead of surgery for DCIS or a benign breast lesion with upgrade potential (BWUP)?Recent FindingsMost contemporary studies are retrospective or registry studies for BWUP and frequently demonstrate lower than historically reported upgrade rates for all entities, consistent with improved imaging and biopsy techniques. Determining which patients should undergo surgical excision involves shared decision-making between the patient and surgeon, with input from breast imaging and pathology. Three international trials offering ac...
Source: Current Breast Cancer Reports - May 4, 2023 Category: Cancer & Oncology Source Type: research
Robot-assisted Nipple Sparing Mastectomy: Recent Advancements and Ongoing Controversies
AbstractPurpose of reviewThe purpose of this review is to summarize the recent technical advancements in RNSM, describe the ongoing teaching programs, and discuss the ongoing controversies.Recent findingsRobot-assisted nipple sparing mastectomy (RNSM) is the newest addition to the armamentarium of surgical techniques for patients who require a mastectomy. The potential benefits of using the da Vinci ® Robotic Surgical System (Intuitive Surgical, Sunnyvale, CA) are the small 3D camera and lighting offering superior visualization, the Endowrist robotic instruments offering greater range of motion, and surgeon being at a sea...
Source: Current Breast Cancer Reports - April 27, 2023 Category: Cancer & Oncology Source Type: research
Current Updates in Management of HER2-Positive and HER2-Low Breast Cancer
AbstractPurpose of ReviewApproximately 1 in 5 breast cancers over-express human epidermal growth factor receptor 2 (HER2). In this review, we discuss the changing landscape of treatments for early and metastatic HER2 breast cancers, new therapies for HER2-low breast cancers, and future investigational directions of HER2-driven disease.Recent FindingsHistorically, HER2 breast cancers have been treated with anti-HER2-targeted therapies in combination with chemotherapy. Recently, clinical trials have established antibody –drug conjugates (ADCs) as an effective additional line of therapy. Previously, patients with HER2-low b...
Source: Current Breast Cancer Reports - April 17, 2023 Category: Cancer & Oncology Source Type: research
Identifying and Reducing Barriers to Breast Imaging
AbstractPurpose of ReviewThe purpose of this review is to discuss disparities in breast health care access and outcomes related to race, gender, cultural diversity, sexual orientation, socioeconomic status, geographic location, and disability. The authors recognize the complexity of eliminating inequalities in health care but are optimistic that all patients will one day have equal access to care through dialogue, acknowledgment, recognition, and action.Recent FindingsAfter lung cancer, breast cancer is the second leading cause of death among American women. Mammography as a preventative screening tool has resulted in sign...
Source: Current Breast Cancer Reports - April 5, 2023 Category: Cancer & Oncology Source Type: research
Breast Imaging Considerations in Symptomatic Young, Pregnant, and Lactating Women
AbstractPurpose of ReviewBenign and malignant breast diseases in young, pregnant and lactating women including pregnancy associated breast cancers will be reviewed.Recent FindingsCompared to breast cancer in older women, poor prognostic indicators such as high nuclear grade, high Ki67 proliferation, estrogen receptor (ER) negativity, and overexpression of human epidermal growth factor 2 (HER2) may be present in young women. Even among ER + /HER2 cancers, young patients have a poorer prognosis. For pregnant women, the timing of care may be personalized based on gestational age, tumor subtype, clinical stage, and family...
Source: Current Breast Cancer Reports - April 5, 2023 Category: Cancer & Oncology Source Type: research
Supplemental Screening for Breast Cancer
AbstractPurpose of ReviewIncreased breast density, among other calculated risk factors, decreases the sensitivity of screening mammography. Several supplementary imaging modalities including breast ultrasound, breast MRI, contrast-enhanced mammography (CEM), and molecular breast imaging (MBI) can be used in addition to screening mammograms to increase the sensitivity of cancer detection in above-average-risk women and will be discussed here.Recent FindingsUltrasound is the most widely used and accessible supplementary screening method that improves the cancer detection rate. MRI, the most sensitive supplemental breast imag...
Source: Current Breast Cancer Reports - April 4, 2023 Category: Cancer & Oncology Source Type: research
The Benefits of Screening Mammography
AbstractPurpose of ReviewBreast cancer is the most commonly diagnosed cancer worldwide. Early detection through screening mammography has been proven to reduce mortality, morbidity, and years of life lost. The purpose of this review is to discuss the benefits of screening mammography and the latest recommendations from the American College of Radiology (ACR).Recent FindingsApproximately 300,000 new cases of breast cancer are diagnosed in the USA yearly. Screening mammography has allowed for early cancer detection with increasing efficacy leading to 500 prevented deaths for every 100,000 women screened and a 5-year survival...
Source: Current Breast Cancer Reports - April 4, 2023 Category: Cancer & Oncology Source Type: research
Advanced Breast Imaging Modalities — DBT, CEM, MBI, PEM, MRI, AI
Abstract
Purpose of ReviewTo discuss how advanced breast imaging modalities can supplement standard breast imaging with mammography, ultrasound, and MRI.Recent FindingsFor the last 40 –50 years, the primary breast cancer screening examination has been mammography which has undergone many changes from xeromammography, film-screen analog, to digital mammography techniques. Digital breast tomosynthesis (DBT) and contrast-enhanced mammography (CEM) are the most recent advances to digital mammography. Molecular breast imaging (MBI) and positron emission mammography (PEM) are nuclear medicine breast examinations that utili...
Source: Current Breast Cancer Reports - April 4, 2023 Category: Cancer & Oncology Source Type: research
Intramammary Metastases from Extramammary Malignancies: An Update
AbstractPurpose of ReviewMetastases to the breast (intramammary metastases, IM) from extramammary malignancies (EM) are uncommon. As prognosis is poor, timely diagnosis is key to direct patients towards appropriate treatment. We will review recent literature regarding the epidemiology, presentation, and diagnosis of IM.Recent FindingsIM commonly present as palpable masses, with imaging findings often based on hematogenous versus lymphatic spread. While many IM are diagnosed with a history of EM, IM may also be the first presentation of distant metastatic disease. In most cases, immunohistochemical testing is required to di...
Source: Current Breast Cancer Reports - March 28, 2023 Category: Cancer & Oncology Source Type: research
De-escalation in DCIS Care
AbstractPurpose of ReviewStandard DCIS management consists of surgery with consideration of adjuvant radiation and endocrine therapy. However, widespread recognition of the overdiagnosis and overtreatment burden in DCIS has led to a reevaluation of this standard. The purpose of this review is to summarize the foundational clinical trials in DCIS and to discuss ongoing efforts in treatment de-escalation.Recent FindingsStandard of care DCIS management is based on large high-quality randomized clinical trials. The results of those trials have been durable over more than a decade of follow-up. However, we now better appreciate...
Source: Current Breast Cancer Reports - March 15, 2023 Category: Cancer & Oncology Source Type: research
Pictorial Review of Male Breast Disease
AbstractPurpose of ReviewMany processes in the male breast are similar to those encountered in female patients, with a few notable differences. While the majority of male breast pathology is benign, a working knowledge of varying imaging presentations of both benign and malignant pathology is necessary to guide appropriate management. The focus of this review is to highlight the classic mammographic and sonographic appearances of benign and malignant pathologies in the male breast.Recent findingsMammography is the initial modality of choice for symptomatic male patients who are 25 years of age or older. In patients young...
Source: Current Breast Cancer Reports - March 10, 2023 Category: Cancer & Oncology Source Type: research
Genetic Considerations in the Locoregional Management of Breast Cancer: a Review of Current Evidence
AbstractPurpose of ReviewBreast cancer is the most commonly diagnosed cancer and is the second leading cause of cancer death in women. Breast cancer screening has significantly improved detection of cancer and reduced mortality however, mortality has plateaued in recent years. As such, identifying ways to improve management decisions to further reduce mortality remains a high priority. Herein, we review the current evidence for locoregional management recommendations in patients with hereditary breast cancer mutations. Additionally, we discuss the potential utility of gene assays in locoregional management decision-making....
Source: Current Breast Cancer Reports - February 28, 2023 Category: Cancer & Oncology Source Type: research
Donor Egg, Surrogacy, and Adoption for Breast Cancer Survivors
AbstractFulfilling the desire to have children is important to breast cancer survivors; however, treatment for breast cancer places women of reproductive age at real risk of reduced fertility or infertility.Purpose of reviewThe purpose of this review is to review family building options for patients with infertility after breast cancer treatment, including the use of donor oocytes, surrogacy, and adoption.Recent findingsPatients with a history of cancer who use donor oocytes seem to have similar implantation, miscarriage, and delivery rates as patients without cancer. For women unable to carry a pregnancy, surrogacy is a g...
Source: Current Breast Cancer Reports - February 8, 2023 Category: Cancer & Oncology Source Type: research
Breast Cancer –Related Lymphedema: the Prospective Surveillance Model, Early Intervention Strategies, and Role of Complete Decongestive Therapy
This study is to review current evidence for prospective surveillance, early intervention and conservative treatment of breast cancer-related lymphedema (BCRL).Recent FindingsBCRL screening is imperative. It must begin at preoperative baseline to avoid misdiagnosis and should include subjective and objective measures and clinical exam. Screening allows for early intervention; however, further research is needed to definitively establish its benefit and identify the appropriate treatment threshold to minimize progression. Complete decongestive therapy (CDT) has remained the gold standard for treatment; however, this is reso...
Source: Current Breast Cancer Reports - January 30, 2023 Category: Cancer & Oncology Source Type: research
Risk Factors for Breast Cancer-Related Lymphedema, Risk Reduction, and Myths about Precautionary Behaviors
AbstractPurpose of ReviewIdentifying and treating long-term complications of cancer treatment, including breast cancer-related lymphedema (BCRL), is important as BCRL negatively impacts the quality of life in both physical and psychosocial domains. The purpose of this review is to discuss recent literature regarding risk factors for lymphedema, review risk reduction strategies, and dispel myths about precautionary behaviors.Recent FindingsEarly detection and treatment of BCRL, including subclinical lymphedema, is encouraged. Lymphovenous bypass and LYMPHA may reduce the incidence of BCRL. Patients no longer need to avoid b...
Source: Current Breast Cancer Reports - January 23, 2023 Category: Cancer & Oncology Source Type: research
